What are the side effects of medication abortion?

Patient's question:

Side effects of medication abortion

Doctor's answer:

The medication currently used for medical abortion, mifepristone, has a dosage that is only 1/4 to 1/3 of the initial dose. As a result, its side effects are not significant, primarily including exacerbation of early pregnancy symptoms and fatigue. The side effects of prostaglandins are mainly gastrointestinal reactions, such as nausea, vomiting, diarrhea, and lower abdominal pain due to uterine contractions. Some individuals may experience fever, dizziness, flushing, and numbness.
To prevent or treat gastrointestinal side effects, compound ethinyl estradiol or metoclopramide can be taken before and after medication. For severe abdominal pain, painkillers and spasmolytics such as pethidine or atropine derivatives may be administered. However, it is important to avoid the use of anti-prostaglandin medications like indomethacin, flurbiprofen, or salicylic acid preparations.
A small number of pregnant women may experience a miscarriage after taking mifepristone. 80% of women using prostaglandin drugs expel the chorionic sac within 6 hours; approximately 10% expel it within one week. Therefore, any bleeding should be monitored for the presence of expelled tissue. If tissue is expelled at home, it should be brought to a doctor for examination to confirm whether it is chorionic tissue.
Based on whether the chorionic sac is expelled or not, follow-up at the medical institution where the medication was administered is required within 8 to 15 days after taking the drug to determine the effectiveness of medical abortion. If medical staff determine that the medical abortion has failed or is incomplete, an artificial abortion procedure must be performed to terminate the pregnancy.
Although the chorionic sac may be expelled during medical abortion, the decidua tissue in the uterus is slowly shed, resulting in a longer bleeding period, with an average duration of 18 to 20 days. Some women may develop anemia or complications such as endometritis or pelvic inflammation due to excessive or prolonged bleeding. Therefore, medical abortion must be performed at a medical institution equipped with emergency